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Living with achalasia like Seahawk Malcolm Smith

On February 3, 2014, Yahoo Sports published an article regarding this years’ Super Bowl MVP, Malcolm Smith, as not only achieving recognition for his Super Bowl performance, but also dealing with a rare swallowing disorder known as achalasia.
 
Achalasia is a rare disorder with a prevalence of 10 cases per 100,000 individuals.  Men and women are equally affected and it is usually diagnosed between the ages of 25 to 60 years.  The disease often comes on slowly and is gradually progressive with problems swallowing solids and liquids, and movement of undigested food particles back up into the mouth unintentionally (bland regurgitation).  Patients also often complain of a burning chest sensation. Other symptoms include hiccups, difficulties belching, and sometimes weight loss.

The condition can be seen with radiology studies including a barium esophagram that shows a dilated, or larger than normal, caliber of the esophagus with a narrowing or tightness at the lower esophageal sphincter. The lower esophageal sphincter is located at the end of the esophagus before it enters the stomach.  An upper endoscopy or camera study is often performed to evaluate the esophagus and stomach closely.  It is ultimately diagnosed with high-resolution esophageal manometry, which is a technique for evaluating esophageal motor dysfunction or movement disorders of the esophagus.

Once achalasia is diagnosed, there are different treatment options ...

Jaundice in newborn babies

As a new parent, you’re understandably eager and excited to leave the hospital and settle into your new routine with your baby. Sometimes, that routine is delayed due to the baby’s blood test confirming hyperbilirubinemia, also known as jaundice.

Jaundice in newborns is caused by an excess of red blood cells. Jaundice is seen as a yellow color to the skin, appearing first at the head (skin and sclera – or “whites of the eyes”) then progressing to the feet. As it decreases, it lessens in reverse. Before birth, the placenta removes bilirubin from the baby’s system; after birth, the baby’s liver takes over. In breast-fed babies, an imbalance between mother’s milk supply and baby’s feeding can lead to a higher-than-expected bili level. In addition to ensuring the baby is feeding well and having enough wet/stool diapers, phototherapy or “bili lights” may be needed. Bili lights help speed up the process by breaking down the bilirubin in the skin.

For phototherapy, your baby will be ...

Cyberknife for spine patients

Cyberknife is a type of radiosurgery used to deliver radiation to a specific part of the body.  This high-energy x-ray system utilizes a robotic arm to deliver focused beam radiation.  While the focused radiation can destroy tumor cells and halt tumor growth, the surrounding tissues have minimal exposure to the radiation, thus sparing them from damage.

When is it used?

CyberKnife is useful for both cancerous and noncancerous tumors.  While it has been used to treat tumors of the head, neck, breast, lung, pancreas, kidney, liver, and prostate, it can be extremely effective for the treatment of  spinal tumors.  

How does CyberKnife work?

Patients who undergo CyberKnife have a specialized treatment plan created for them by their neurosurgeon, radiation oncologist, and a medical physicist.  These personalized plans take into account the specific location of the tumor in the body, including the tumor type, shape, size, surrounding tissues and organs (to minimize radiation exposure) and the exact quantity of radiation the tumor cells are receiving,

Why not just have surgery?

Any ....

Troubles swallowing food or liquids – what does it mean?

Dysphagia refers to the sensation of food or liquid being delayed or hindered from the mouth to the stomach.  This abnormality is increasingly recognized as an important concern that requires attention and study.  There are many causes of impaired swallowing, which are categorized into two types, mechanical, a structural barrier to food bolus movement, and motility disorders, involving abnormal muscle movement.  There are also two major anatomical sites, oropharyngeal and esophageal. 
 
Oropharyngeal dysphagia is related to problems with the initiation of the swallows and clearing the food bolus from the mouth to the esophagus.  This usually occurs within a second of swallowing and you may feel that you cannot initiate a swallow or food hangs up in the neck region.  A test that is commonly used to evaluate this is a modified barium swallow or videofluoroscopic swallowing study.  This study provides critical information on inability or excessive delay in initiation of swallowing, unintentional inhalation of food, unintentional expulsion of food from the nose or mouth, and/or abnormal retention of food in the back of the throat after swallowing.  Most ...

January 25 essential tremor seminar

If you or someone you care about shakes a lot—it could be essential tremor (ET) or another movement disorder. Essential tremor is a disorder affecting approximately 10 million Americans. This progressive neurological condition can cause the hands, head, voice, legs or trunk of the body to shake and can cause significant disability. It is often confused with Parkinson’s disease or dystonia. Because of stereotypes and lack of awareness, many people with ET never seek medical care, though most would benefit from treatment.
 
In an upcoming event, Dr. Ryder Gwinn will explain the causes, diagnosis,  research and treatment options for essential tremor.
 
Date: Saturday, January 25
Time: Check-in 9:30am/Program 10am-Noon
Location: Bellevue Hilton, 300 112 Ave SE, Bellevue, WA
 
There is no charge for the event but please note, parking in the Bellevue Hilton lot is $5.

Registration is required - call 888-387-3667 or visit www.essentialtremor.org/seminars

 

 
 

How to treat PFS runner's knee

Patellofemoral pain constitutes a quarter of the injuries to the knee.  Kneecap pain can be both debilitating and frustrating; prolonged pain can limit physical activity and cause those suffering from it to abandon their recreational and sporting activities. 

Patellofemoral pain usually manifests as a gradual onset of pain around the edge or underneath the kneecap during physical activities.  Common activities such as descending hills or stairs, squatting, running, or sitting for long periods of time can all aggravate the pain and cause soreness. 

How your knee works

patellofemoral pain image from http://www.moveforwardpt.com/The knee joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap).  The patellofemoral joint refers to the kneecap and the groove (trochlea) in the femur in which the patella sits.  The four muscles of the quadriceps all attach to the patella.  The patella is a sesamoid bone (the bone is embedded within the tendon) and it plays a crucial role in the function of the leg by lengthening the lever arm of the muscles and tendons of the quad to maximize power and function and by acting as a shield to protect the knee from direct trauma.  The cartilage covering the kneecap within the knee joint acts as a shock absorber, protecting the underlying bone from stress.  With running and jumping, the knee (and its overlying cartilage) can experience forces up to 8 times bodyweight.  The cartilage itself does not have a nerve supply, but the bone underneath has an extensive nerve supply and these nerves become painful when the cartilage is not functioning properly to pad and protect the bone.

In patellofemoral syndrome, or PFS (also known as runner’s knee), the cartilage undersurface of the patella become angry, inflamed, irritated, and the kneecap hurts.

How to treat PFS or runner’s knee

  1. Loosen things up.  Use a foam roller to roll out the quad muscle and the illiotibial (IT) band.  These tissues all hook into the kneecap and can contribute to pain when they are tight.
     
  2. Make things stronger.   In the early recovery period (the first several weeks when you are just starting out on your recovery journey) ....

Gluten allergy: myth or fact?

Gluten is a hot topic these days, and is hitting the headlines again. Why? At the American College of Allergy, Asthma, and Immunology annual meeting, Dr. David Stukus (a pediatric allergist) set out to clarify frequent myths that he encounters in his practice.  So, why is he saying that gluten allergies do not exist?

Gluten is a protein found in foods processed from wheat and related grain products.  In celiac sprue (affecting up to 1% of adults), gluten intake leads to damage of the small intestine, impairing its ability to absorb nutrients.  I like to imagine that a healthy small intestine is like a shag carpet, and small intestine affected by active celiac sprue is more like a tile floor.  Celiac sprue is not a gluten allergy, but rather an autoimmune condition where the gluten is triggering an inflammatory response in the body.

Studies find that ...

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